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Expert Q&A: Demi Lovato and Relapses

By Kathleen DohenyJuly 25, 2018

Pop star Demi Lovato, 25, known for talking and singing about about her sobriety efforts, was hospitalized in Los Angeles on Tuesday. While the cause was not released, a spokeswoman for the singer told various media outlets that Lovato “is awake and with her family.”

But just last month, Lovato released the song “Sober,” with heartbreaking lyrics about relapse, an ongoing struggle for many with addictions. In part, the song says:

“Momma, I’m so sorry, I’m not sober anymore

And daddy, please forgive me for the drinks spilled on the floor

To the ones who never left me

We’ve been down this road before

I’m so sorry, I’m not sober anymore.”

In 2010, Lovato entered a rehab facility to deal with issues of depression, bulimia, addiction, and cutting. In 2016, she told People magazine that she has previously struggled with alcohol, cocaine and OxyContin.

WebMD asked Romas Buivydas, PhD, a clinical psychologist and vice president of clinical development at Spectrum Health Systems in Worcester, MA., about relapses, how common they are, why they happen, and whether Lovato’s fall from grace will affect her fans, many of whom look to her for inspiration in their own sobriety journey.

WebMD: How common is relapse?

Buivydas: It can range. In the field, 40% to 60% is typical and the commonly cited statistic. Relapse is often a part of recovery. Even though you are doing the right thing, exercising, taking your medication, you can still relapse.

It can make you stronger, however.

There are all forms of relapse. A lapse, as it’s called in the field, is (for example) you took an oxycodone. You may [then] need … a little more time with your therapist.

A relapse, on the other hand, might mean leaving your therapist and using for 2 weeks. And you may need detox and then get back into treatment.

WebMD: What could drive a relapse?

Buivydas: Fear of something. Fear of losing control. Fear of losing a good feeling. Some say, ‘Hey I am feeling well, someday I may not.’ It may be fear of losing a career, a loved one, status, or fear of losing control. In the majority of relapses, the trigger is often a fear of something, when you boil it all down.

There are folks who have been clean and sober for 20 years and have relapses. A trigger could also be seeing someone who had a relapse themselves. Or you get fired. Or your status changes.

For some it could be an emotional trigger. It could be anger as a trigger.

WebMD: Can people learn the potential warning signs of a relapse and head it off?

Buivydas: Absolutely. A good therapist who knows addiction will be able to teach different skills to be aware of the different signs and know what to do, and to know what is the crisis plan.

A therapist for example would say, ‘What are your triggers?’, and ‘What would you do if all of a sudden you had this overwhelming feeling that you wanted to use? Let’s go over a crisis plan.

‘Can you call your sponsor? If he or she is not available, can you go to someone who is going to be supportive?’

WebMD: What does having this crisis plan in place do?

Buivydas: It gives a quick resource. It may give them some peace of mind. In a crisis you may not think clearly of what to do. A lot of people carry a crisis card or throw it into their phone as notes, put the numbers [of supportive people] in their favorites list.

WebMD: Will Lovato’s ordeal make her fans in recovery more likely to relapse?

Buivydas: That depends on the individual. It could pose as a trigger for some to relapse. For others it could strengthen their resolve not to relapse. It humanizes the celebrity. So yes, this is a relapse, much like any disease can relapse. You can have a relapse of cancer. And addiction is a disease.

So, it could strengthen a fan’s resolve. They may think, ‘Hey she did OK [before it happened]. Maybe something, some stressor happened. Maybe some will say, ‘I will pay more attention to my own triggers.’

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